Got Arthritis? Take Care of Your Teeth

Periodontal disease and rheumatoid arthritis may be linked

(RxWiki News) If those aching joints are a result of rheumatoid arthritis, it may be a signal to take extra care of your teeth.

That’s the recommendation from a new study, led by Elliot D. Rosenstein, MD, director of the Institute for Rheumatic and Autoimmune Diseases at Overlook Medical Center in New Jersey. Rheumatoid arthritis (RA) and periodontal disease may be connected, this study found. Patients with one condition often have the other as well.

Treating periodontal disease may improve patients’ response to treatment for RA, Dr. Rosenstein and colleagues said.

“The connection between rheumatoid arthritis and teeth has been discussed for decades,” Dr. Rosenstein said in a press release. “Our hypothesis shows that properly treating periodontal disease will have a favorable impact on rheumatoid arthritis, diminishing the intensity of joint inflammation and making patients more responsive to the therapies they use.”

Dr. Rosenstein, along with co-authors Dr. Laura J. Kushner, a periodontist, and Dr. Neil Kramer, a rheumatologist, published an article on RA and periodontal disease in the December 2014 Current Oral Health Reports. Dr. Rosenstein will present their findings March 13 at the International Association for Dental Research General Session in Boston.

RA and periodontal disease are both inflammatory conditions. Typical RA symptoms include pain and stiffness in the joints, fatigue and erosion of bone in the joints. Women are more likely to develop RA than men. Periodontal disease includes symptoms like redness and swelling of the gums, tooth decay and gum infections.

The bacterium that causes periodontal disease secretes an enzyme. People with RA have high levels of antibodies to citrullinated peptides — antibodies that may be caused by this enzyme.

Some people with RA do not have periodontal disease, however. Although Dr. Rosenstein and team were not yet saying RA is caused by periodontal disease, they did say the connection was well-established.

Their hypothesis is that treating periodontal disease may decrease joint inflammation in RA. Treating periodontal disease may also help patients respond better to therapy for RA, Dr. Rosenstein and team said.

Dr. Rosenstein and colleagues recommended four major strategies for people with RA: fatty acid supplementation, smoking cessation, weight loss and proper dental care.

Fatty acid supplementation with borage seed oil and fish oil has been found to help people with RA and periodontal disease by reducing inflammation. And smoking has been implicated as a contributing factor in both diseases.

Weight loss may relieve some of the stress on joints for people with RA. Both RA and periodontal disease are linked to heart disease, and obesity can increase the risk of heart disease.

Early and regular dental care can also help prevent and treat periodontal disease.

Patients with RA should be referred for dental evaluation and care early in the course of treatment, Dr. Rosenstein and team said.

Dr. Rosenstein and colleagues disclosed no funding sources or conflicts of interest.

Review Date: 
March 12, 2015